Fast Five Quiz: How Much Do You Know About Anal Cancer?

Elwyn C. Cabebe, MD


October 30, 2017

Anal cancer is typically found in one of the following ways:

  • As an incidental finding on a biopsy for another reason

  • During surveillance for anal intraepithelial neoplasia (precancerous lesion)

  • De novo

Imaging for all patients with anal cancer should include chest/abdominal/ pelvic CT to evaluate for enlarged lymph nodes and metastatic spread. Female patients should be evaluated with a thorough gynecologic examination, including screening for cervical cancer. PET/CT can be considered in certain clinical scenarios.

In patients with anal squamous cell carcinoma, colonoscopy is also recommended because colorectal neoplasm is discovered at the time of diagnosis in 15% of cases, although no link between colon and rectal cancer and anal cancer has been established.

Currently, no major regulatory or professional body recommends anal cancer screening for the general population, and controversy surrounds the questions of which patients are candidates for screening and what techniques should be used. In general, screening is recommended in patients at high risk for anal cancer, such as the following:

  • Some immunocompromised patients (eg, kidney or liver transplant recipients)

  • Patients with anogenital warts

  • HIV-positive men who have sex with men

For more on the workup of anal cancer, read here.


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